Basic Information
Provider Information
NPI: 1003154790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IVOKO
FirstName: HOPE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2054 TILLOTSON AVE
Address2:  
City: BRONX
State: NY
PostalCode: 104751560
CountryCode: US
TelephoneNumber: 7186712100
FaxNumber:  
Practice Location
Address1: 2054 TILLOTSON AVE
Address2:  
City: BRONX
State: NY
PostalCode: 104751560
CountryCode: US
TelephoneNumber: 7186712100
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/30/2013
LastUpdateDate: 01/30/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X664295NYY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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